Apparatus for manipulating the vertebral column of human patients

ABSTRACT

An apparatus for facilitating manipulation of the body of a human patient for the treatment of vertebral disorders comprises an upright support from which a pivotal arm is cantilevered and has at its ends a suspended traverse. The traverse is provided with knee-supporting shells or saddles from which the patient may be suspended head downward to permit manipulation. The traverse may also carry a roll or drum adapted to carry the patient in a bent-over condition to permit manipulation of the spine.

United States Patentv Schwab 51 May 2, 1972 [54] APPARATUS FORMANIPULATING THE VERTEBRAL COLUMN OF HUMAN PATIENTS [72] Inventor:Raymond Schwab, Freihermweg 13, 43

Essen, Germany [22] Filed: June 15, 1970 [21] Appl.No.: 45,978

[30] Foreign Application Priority Data Feb. 4, 1970 Germany ..P 20 04932.5

[52] U.S. Cl ..128/69, 128/75, 5/87 1 [58] Field of Search 128/69, 68,75, 83, 84, 24;

[56] References Cited UNITED STATES PATENTS 2,633,124 3/1953 Yellin..128/75 2,650,725 8/1953 Hoyer et a1. .....2l4/75 3,222,029 12/1965l-lildemann ..5/87 X 2,821,406 l/l958 I-Ioyer et a1. ..5/87 X 1,876,8328/1932 Bancroft.... ...5/87 X 572,139 12/1896 Voss 1 28/75 1,804,4415/1931 Silva ...l28/75 3,491,385 I/1970 Werner ..5/327 FOREIGN PATENTSOR APPLICATIONS 1,210,125 1966 Germany ..5/86

Primary Examiner-Richard A. Gaudet Assistant Examiner-J. YaskoAttorneyl(arl F. Ross [57] ABSTRACT An apparatus for facilitatingmanipulation of the body of a human patient for the treatment ofvertebral disorders comprises an upright support from which a pivotalarm is cantilevered and has at its ends a suspended traverse. Thetraverse is provided with knee-supporting shells or saddles from whichthe patient may be suspended head downward to permit manipulation. Thetraverse may also carry a roll or drum adapted to carry the patient in abent-over condition to permit manipulation of the spine.

7 Claims, 6 Drawing Figures Patented May 2, 1972 3,659,594

3 Sheets-Sheet l Patented May 2, 1972 3 Sheets-Sheet INVENTOR.PAY/Va/Vfl SKY/W45 APPARATUS FOR MANIPULATING THE VERTEBRAL COLUMN OFHUMAN PATIENTS FIELD OF THE INVENTION My present invention relates to anapparatus for facilitating manipulation of the vertebral column of ahuman patient and, more particularly, to a device adapted to be used byorthopedists, chiropractors, physicians, technicians and otherindividuals to assist patients suffering from vertebral disorders.

BACKGROUND OF THE INVENTION In recent years, the treatment of vertebraldisorders by manipulation of the spinal column or vertebral column ofthe neck, shoulders, legs, hips and pelvic areas of the body and variousdistortions of the torso have increasingly been accepted as treatmentsfor disorders of the spinal column such as slipped disks, dislocation ofthe individual vertebra, excessive strain on the muscles, tendons andligaments associated with the vertebrae and the like. The disorderswhich are treated in this fashion also include strained and tornligaments of the vertebrae and muscular strains associated therewith.

The manipulations of the patient to relieve such disorders havetheretofore included placing the patient upon a table and, with thepatient in a prone position, so rotating the shoulders, hips, legs andtwisting the torso so as to relieve the disorder and permit dislocatedvertebral members to return to their original position. These practiceshave generally been extremely painful. Another disadvantage of theconventional technique is that, with the patient in a prone position,rotation of the torso or its appendages has the tendency to applyconsiderable stress to dislocated members and can lead to aggravateddisorders with even greater pain than is sustained by the patient fromthe original disorder.

OBJECTS OF THE. INVENTION It is, therefore, the principal object of thepresent invention to provide an improved apparatus for facilitatingmanipulation of the vertebral area of the body with less pain for thepatient.

Another object of this invention is to provide an apparatus of thecharacter described facilitate manipulation of the spinal column and,especially, relieve ligament strain and slipped disk disorders and likedislocations, and which is more conducive to use by a physician,chiropractor, technician or other personnel concerned with suchorthopedic disorders.

It is also an object if this invention to provide an improved apparatusfor the treatment of vertebral disorders which will involve less dangerof aggravation of the disorder than heretofore.

Yet a further object of my invention is to provide an apparatus of theclass described which is of relatively low costs, is of greatversatility, is suitable for use with various vertebral disorders and,in addition, is simple to operate.

SUMMARY OF THE INVENTION These objects and others which will becomeapparent hereinafter are attained in accordance with the presentinvention, with a apparatus comprising a support, generally in the formof an upright or frame, from which an arm is cantilevered at an upperlocation, the arm being swingable on the support and having at its freeend knee-support members from which the patient can be suspended tofully relieve the spine'and permit manipulation of the patient.

According to an important feature of this invention, the free end of theswingable arm is formed with a traverse or bar upon which upwardlyconcave shells are provided, the traverse extending horizontally. Theshells are preferably saddles designed to fit beneath the knee joint ofthe patient and may be provided with means locking the side or legportion adjacent the knee joint to the traverse to prevent slippage ofthe patients knees from the shell. Both the shells and the retainingmeans, e.g. straps, can be formed with cushion or padded surfaces. Sincethe entire torso of the patient hangs freely downwardly, there is acomplete destress of thevertebral column and the latter can bemanipulated vertebral by vertebra. In this position of the patient, thetorso can be twisted, rotated, flexed or otherwise manipulated proximalto the shoulders, to the hips or at any intermediate location withoutthe danger of lockage of the return of any dislocated ver tebrae.Moreover, I have found that the aforementioned vertebral disorders canbe treated effectively with thepatientsuspended at the knee, inaccordance with the present invention, by a roller which is applied to.the patient's back and rotated thereagainst through, say, one-fifth toone-sixth of a rotation. The roller may be used vertebra by vertebra torestore any dislocated member into its proper position.

According to another feature of this invention, power means is providedbetween the support, which may comprise an upright post and thecantilevered arm for raising and lowering the latter while the patientis suspended therefrom, while locking means affixes the arm in thedesired angular position with respect to its pivot. When the power meansincludes a fluid-responsive device, locking can be accomplished bycutting ofi fluid flow to and from the device. Preferably, thelast-mentioned means includes a hydraulic cylinder which may be suppliedby a hydraulic pump, the latter being mechanically actuated by theoperator using, for example, the principles of a hydraulic jack. Theadjustment may, however, also be accomplished by means of rotaryhydraulic or electric motors, in which case the motor should bereversible as may be provided with controls on a support or armactuatable by the operator and can be coupled with the arm with atransmission capable of resisting a reverse drive by the arm of themotor under the weight of a heavy patient. A suitable transmission willin this case be constituted by a worm/worm wheel arrangement.

Yet another feature of this invention resides in the provision betweenthe cantilevered arm and the traverse of a swivel joint enablingrotation of the traverse about a vertical axis and provided with meansfor locking the traverse at a pre-determined orientation with respect tothe vertical plane through the arm. The maintain the traverse in theproper position with respect to the free end of the arm, this connectingmeans and swivel arrangement may be rotatable about a horizontal axisformed on the free end of the arm and likewise provided with a lock torestrict pendulum-type swinging of the traverse. Alternatively or inaddition, the traverse may be swivelable with respect to the connectingmeans.

Yet another feature resides in the provision of means on the traversefor supporting portions of the body independently of the knee shellsdescribed above. For example, I may suspend a support roll with agenerally horizontal axis by flexible members, e.g. chains, upon the endof the traverse to provide a rest for a patient who may be bentthereafter with the roll supporting the abdomen when treatments of thepatient in this position are desired. In this case, the lower half ofthe torso and the upper half of the torso hang on opposite sides of theroll and are destressed while the intermediate portions of the verticalcolumn are placed under tension. Means, eg a sling, may be provided atthe center of the traverse for carrying a head support so that tensionmay be provided in the neck region for manipulation of the vertebralcolumn there.

A further feature of the invention resides in the provision of means forrollingly shifting the support so that it can be brought to the bed of apatient, moved away from the treatment area or otherwise positioned atany desired location. When a fixed support is desired, it may be mountedon the wall or on the floor.

DESCRIPTION OF THE DRAWING The above and other objects, features andadvantages of the present invention will become more readily apparentfrom the following description, reference being made to the accompanyingdrawing in which:

FIG. 1 is a side-elevational view of an embodiment of the apparatusaccording to the present invention;

FIG. 2 is a front view thereof;

FIG. 3 is a plan view of the apparatus;

FIG. 4 is a perspective view of a modified embodiment thereof; FIG. 5 isa detail view of a part of the device of FIG. 4; and

FIG. 6 is a diagrammatic view of another drive for the system.

SPECIFIC DESCRIPTION In FIGS. 1 3 of the drawing, I show an apparatusfor facilitating the manipulation of a patient sufiering from avertebral disorder which comprises a support frame 1, having a post 2which is mounted upon a movable carriage 3, the latter comprising a pairof forwardly extending arms 3a and 3b defining a trapezoid. A pedestal30 along the small side of the trapezoid supports the post 2 and anchorsa pair of upright, inverted-L stiffening tubes 4 which rise from thepedestal and are anchored in a yoke 40 surrounding the. post 2. Wheels3d and 3e are carried by the legs 3a and 3b at the broad base of thetrapezoid while wheels 3f and 3g at the end of the pedestal 30 supportthe narrow base. The legs 3a and 3b are designed to be receivablebeneath the bed of a patient to enable the apparatus to be used evenwith bedridden patients. It will be apparent that the wheels 3c 3g maybe removed when it is desired to fix the apparatus on the floor of thetreatment room and that the legs 3a and 3b can be mounted on the floorby bolts or the like. Similarly, brackets may be used to fix the post 2directly to a wall if necessary.

At the upper end of the post 2, there is provided an outwardly andforwardly extending cantilevered arm 5 which is swingably mounted on thepost 2 at a horizontal pivot extending perpendicularly to the plane ofthe arm swing (in FIG. 2 The free end of the arm 5 is provided with adog leg. 5a downwardly. I

To raise and lower the arm 5 controlledly, e.g. while a patient,represented in dot-dash lines in FIG. 4 is suspended therefrom, Iprovided a hydraulic jack 7, 8. The hydraulic cylinder of this jackremoves a piston 7a which can be extended (FIG. 2) to elevate the arm 5and is pivoted to the latter at 7b. The cylinder 7 is, in turn,swingably mounted at 70 between a pair of trunnions 2a and 2b on thepost 2, while a hydraulic pump 8a s provided at the base of the cylinder7. In accordance with the conventional hydraulic-jack principles, thearm 8 is swingable at 8b about an axis transverse to the axis of thecylinder 7 and is coupled at 80 with a pump piston which, uponreciprocation, forces fluid intothe cylinder 7 to extend the jack andraise the arm 7. When a valve is opened, it permits draining of thecylinder 7 whereas reciprocation of the arm 8 with the valve closedextends the piston, prior to displacement thereof. It will be apparentthat with reciprocation of the arm 8, the arm 5 may be set at anyheight, e.g. an extreme upper position as represented in dot-dash linesat 9 in FIG. 1 or at an extreme lower position as represented in solidlines in this Figure.

At its free end 5a, the arm 5 is formed with a traverse 10 in the formof a horizontal bar carrying a pair of doubly curved saddle-shaped kneesupports engageable below the knee of a patient who may be supportedfrom the traverse. The new supports 11 are horizontally spacedsymmetrically on opposite sides of the median plane P in the position ofthe apparatus in which the bar 10 lies perpendicular to this plane, andmay be cushioned to ease the pressure upon the legs of the patient. Theleg is bent at the knee backwardly about the saddles 11 and can be heldin place by straps inserted through the openings 11a and 11b in thewalls of the saddle. The belts preferably also are padded.

The traverse 10 is integral with a sleeve 1 1 which, in turn, isswingably mounted upon the free end of the arm 5 and constitutes aswivel member be apparent hereinafter. A shaft 120 is received in thesleeve 12 and supports the latter,

the sleeve being rotatable about the vertical axis of the shaft betweenthe solid-line position illustrated in FIG. 1, in which the traverse l0lies perpendicular to the median plane 1, into a position as shown indot-dash line at 13 which may be at right angles to the originalposition. The swivelability of the traverse enables twisting of thetorso by the practitioner and permits him to bring the patient into theposition most satisfactory for him. As described in connection withFIGS. 4 and 5, the traverse 10 may be lockable with respect to the shaft12a at the desired position. Alternatively, the shaft may be fixed tothe sleeve 12 so as to be rotatable therewith, in which case a swivel isprovided at 5b by the arm 5. As best seen in FIG. 3, the swivel mayconsist of a ball 12b rigid with the shaft 12a and rotatable in a socketformed by the arms 5b and 5b' of a bifurcation at the swivel joint 5b.Thus rotation is permitted about an axis A (vertical axis) illustratedin FIG. 1 and the horizontal axis B represented in FIG. 3. To lock theswivel against rotation about either axis, a lever 14 and a clampingscrew 14a are provided. The patient may be lifted by the arm 5 with thescrew 14a in its released position so that the sleeve 12 remainsvertical during elevation and descent of the arm 5. When the latter hasreached its desired height, clamp 14, 140, 5b and 4b" is operated tolock the swivel.

The apparatus illustrated in FIGS. 1 3 is used by shifting the entirestructure 1, for example, to the bed of a patient and inserting thepatients knee over the saddles 11. The thigh or leg areas may be held inplace with cushioned straps as previously described, whereupon lever 8is reciprocated to extend the piston rod 7a of the jack 7 and raise thearm 5 to its position illustrated in FIG. 1, the clamp 14, 14a etc.having previously been loosened. The arm may then be brought into theposition shown at 9 in FIG. 1. In this position, the patient hangs headdownwardly and freely with complete relief of pressure on the vertebralcolumn. At a position convenient for the doctor, the clamp 14, 14a islocked and the back of the patient worked by torso, shoulder and hipmanipulation or by individual-vertebra manipulation as previouslydescribed. I have found that highly satisfactory results are obtainedwhen the dislocated members are manipulated with the aid of a rollerprovided at its outer extremities with handles gripped by thepractitioner and adapted to be thrust against the back of the patientwhile he is suspended from the apparatus. The roller may be formed witha circumferential recess at an intermediate location so as toconcentrate its pressure laterally of the spinal column and graduallywork dislocated members back into place. The roller may besmooth-surfaced or may be provided with projections as required. Thishas been found to provide considerable relief for pinched nerves andpressures arising from dislocations in a substantially painless mannerand without placing the pinched portions under mechanical stress bysqueezing or rubbing. The patient may, moreover, by placed in anydesired position and can be pulled downwardly to provide a slighttraction. After treatment, the patient may be returned to his bed orplaced upon a table by lowering of the arm 5 by use of the valve 8d todrain the hydraulic-jack cylinder. The system may be used as describedearlier and is illustrated in FIG. 4, with a roller arrangement uponwhich the patient may lie abdomen downward or a cradle or slingengageable with the head and general area to stretch the neck.

In FIG. 4, I show a modification of the system of FIGS. 1 3 wherein thelegs 103a, 103b are provided not only with the wheels 103d and 103e, butalso with friction members 103d and l03e' similar to door stops to lockthe carriage 103 against movement on the floor when the apparatus isplaced in the proper position. The pedestal 103c is likewise providedwith a pair of friction devices 103] and 103g as well as with the wheels103f and 103g. Along the carriage, I may mount an inverted-U bar 120,e.g. via sleeves 121 having locking pins 122 which may be withdrawn torelease the bar 120 or position it at various heights. The bar 120 mayserve as an anchor for the legs of the patient when the patient isplaced abdomen downwardly on a roller 123 suspended by chains 124 and125 from the ends of the traverse bar 110. For this purpose, the

traverse bar 1 may be provided with an eye 126 at each end as best seenin FIG. 5.

In FIG. 4, the stiffening tubes 4 of FIGS. 1 3 have been eliminatedalthough hoops 104a and 1041; are provided on opposite sides of the post102 to permit the apparatus 101 to be maneuvered into position readily.

The hydraulic jack 107 is here shown to be provided with a pump plunger1086 which is reciprocable about an axis lying in the plane of the post102 by the arm 108 while a valve handle 108d permits draining of thejack to lower the arm 105. The arm 105 carries the swivelable shaft112a, connecting sleeve 112 and traverse 110 as previously described.The knee-engaging saddles 1 l l are here shown to be provided with thestraps Illa while an eye 127 is provided at the center of the traverseto receive the upper block of a block-and-tackle arrangement 128, thelower block 129 of which carries a pin and head sling 130. When thepatient is seated beneath the arm 105, the sling may be placed about hishead and beneath his chin and raised and lowered manually by theblock-andtackle arrangement 128 or hydraulically by the jack arrangement107, 108. The clamp 114a is here shown to be actuated by an arm 114which, to avoid interference with the practitioner, extends along thearm and has a handle 114b located close to the post.

Frequently it is desirable to swing the patient about a vertical axisand I may provide a handle 131 directly on the traverse 110 to lock thelatter at a desired position about the vertical axis. The handle 131 mayhere be provided with a shaft 132 whose thread 133 enables axialdisplacement of the shaft 132 to bring a shoe 134 into engagement withthe shaft 1120 which is here freely rotatable in the sleeve 112 butprevented from moving axially thereon by a head 135. Release of thescrew 132 permits rotation of the traverse 1 10 about the vertical axis.A similar handle may be provided to permit angular orientation of theshaft 110 about a horizontal axis with respect to the sleeve 1 12.

In FIG. 6, I show an alternative drive for the arm 205 which is herecoupled with a sector gear 240, driven by a worm 241, the latter beingoperated by a motor (hydraulic or electric) 242 in the post 202. Theapparatus of FIGS. 4 6 is operated, of course, in the manner describedwith respect to FIGS. 1 3.

The improvement described and illustrated is believed to admit of manymodifications within the ability of persons skilled in the art, all suchmodifications being considered within the spirit and scope of theinvention except as limited by the appended claims.

I claim:

1. A device for facilitating treatment of vertebral disorders,

comprising:

an upstanding support;

an arm pivotally mounted at one end on said support for movement about agenerally horizontal axis in a generally vertical plane and having afree end remote from said support, said free end being bent downwardlyat an angle to the remainder of said arm and having a swivel jointconnected thereto;

a traverse bar depending from said swivel joint and having a generallyhorizontal orientation while being rotatable and swingable relative tosaid free end of said arm;

a pair of doubly-curved saddle-shaped shells mounted on said traversebar to opposite sides of said swivel joint for engagement behind theknee of a patient suspended from said traverse bar, said shellsconforming generally to the shape of the knee joint; and

locking means for fixing said swivel joint and securing said traversebar against movement relative to said free end.

2. The device defined in claim 1, further comprising power means betweensaid support and said arm for raising and lowering said traverse bar byswinging said arm.

3. The device defined in claim 2 wherein said power means is a hydraulicjack having a cylinder member and a piston member, one of said membersbeing pivotally connected to said support and the other of said membersbeing pivotally connected to said arm. h

4. The device defined in claim 2 wherein said power means includes amotor.

5. The device defined in claim 1, further comprising means for mountingauxiliary body-engaging units upon said traverse bar.

6. The device defined in claim 1 wherein said support is mobile.

7. The device defined in claim 1 wherein said support comprises wheeledcarriage shiftable along a floor and a post extending upwardly from saidcarriage along one side thereof and formed with a horizontal pivotswingably carrying said arm at the upper end of said post; said arm iscantilevered over said carriage; and

said power means includes a fluid cylinder pivotally mounted on saidpost, a piston slidably received in said cylinder and pivotallyconnected to said arm, and pump means provided with an actuating handleand connected to said cylinder for raising and lowering said arm; andsaid device further comprises a torso-support roll and a headsupportsling and means on said traverse bar for mounting said torso-supportroll and said head-support sling on said arm.

1. A device for facilitating treatment of vertebral disorders,comprising: an upstanding support; an arm pivotally mounted at one endon said support for movement about a generally horizontal axis in agenerally vertical plane and having a free end remote from said support,said free end being bent downwardly at an angle to the remainder of saidarm and having a swivel joint connected thereto; a traverse bardepending from said swivel joint and having a generally horizontalorientation while being rotatable and swingable relative to said freeend of said arm; a pair of doubly-curved saddle-shaped shells mounted onsaid traverse bar to opposite sides of said swivel joint for engagementbehind the knee of a patient suspended from said traverse bar, saidshells conforming generally to the shape of the knee joint; and lockingmeans for fixing said swivel joint and securing said traverse baragainst movement relative to said free end.
 2. The device defined inclaim 1, further comprising power means between said support and saidarm for raising and lowering said traverse bar by swinging said arm. 3.The device defined in claim 2 wherein said power means is a hydraulicjack having a cylinder member and a piston member, one of said membersbeing pivotally connected to said support and the other of said membersbeing pivotally connected to said arm.
 4. The device defined in claim 2wherein said power means includes a motor.
 5. The device defined inclaim 1, further comprising means for mounting auxiliary body-engagingunits upon said traverse bar.
 6. The device defined in claim 1 whereinsaid support is mobile.
 7. The device defined in claim 1 wherein : saidsupport comprises wheeled carriage shiftable along a floor and a postextending upwardly from said carriage along one side thereof and formedwith a horizontal pivot swingably carrying said arm at the upper end ofsaid post; said arm is cantilevered over said carriage; and said powermeans includes a fluid cylinder pivotally mounted on said post, a pistonslidably received in said cylinder and pivotally connected to said arm,and pump means provided with an actuating handle and connected to saidcylinder for raising and lowering said arm; and said device furthercomprises a torso-support roll and a head-support sling and means onsaid traverse bar for mounting said torso-support roll and saidhead-support sling on said arm.